ArticleCanadian journal of gastroenterology & hepatology2015
Partially covered self-expandable metal stents versus polyethylene stents for malignant biliary obstruction: a cost-effectiveness analysis.
Article in Canadian journal of gastroenterology & hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03870386 (EUS-guided Biliary Drainage of First Intent With the Lumen Apposing Metal Stent vs. ERCP in the Management of Malignant Distal Biliary Obstruction), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
EUS-guided Biliary Drainage of First Intent With the Lumen Apposing Metal Stent vs. ERCP in the Management of Malignant Distal Biliary Obstruction: a Randomized Controlled Trial
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Plastic vs. Self-Expandable Metal Stents for Palliation in Malignant Biliary Obstruction: A Series of Meta-Analyses.The American journal of gastroenterology · 2017Pooled it
- Contemporary Landscape of Medical Technology in Gastroenterology Between 2013 and 2023.The American journal of gastroenterology · 2025Review
- Efficacy Analysis of Suprapapillary versus Transpapillary Self-Expandable Metal Stents According to the Level of Obstruction in Malignant Extrahepatic Biliary Obstruction.Gut and liver · 2023Article
- Utilizing 4D Printing to Design Smart Gastroretentive, Esophageal, and Intravesical Drug Delivery Systems.Advanced healthcare materials · 2023Review
- Use of stents in patients undergoing chemotherapy for borderline resectable pancreatic cancer-causing biliary obstruction while awaiting surgery: A cost-effectiveness analysis.Endoscopy international open · 2021Article
- Survival, stent patency, and cost-effectiveness of plastic biliary stentJGH open : an open access journal of gastroenterology and hepatology · 2021Article
- Early cholangioscopy-assisted electrohydraulic lithotripsy in difficult biliary stones is cost-effective.Therapeutic advances in gastroenterology · 2021Article
- Interventional Treatment for Cholangiocarcinoma.Frontiers in oncology · 2021Review
- Telepresence-teleguidance to facilitate training and quality assurance in ERCP: a health economic modeling approach.Endoscopy international open · 2020Article
- Endoscopic ultrasound-guided biliary drainage for distal malignant obstruction: a systematic review and meta-analysis of randomized trials.Endoscopy international open · 2019Article
- Inflammation-based prognostic scores in patients with extrahepatic bile duct lesions treated by percutaneous transhepatic biliary stenting combined withClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2019Article
- Plastic stents are more cost-effective than lumen-apposing metal stents in management of pancreatic pseudocysts.Endoscopy international open · 2018Article
- Observational
- EUS-guided biliary drainage in malignant distal biliary obstruction: An international survey to identify barriers of technology implementation.Endoscopic ultrasoundArticle
- Endoscopic ultrasound-guided antegrade stenting in an occluded biliary self-expandable metal stent.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledBACKGROUND⁄
objectivePartially covered self-expandable metal stents (SEMS) and polyethylene stents (PES) are both commonly used in the palliation of malignant biliary obstruction. Although SEMS are significantly more expensive, they are more efficacious than PES. Accordingly, a cost-effectiveness analysis was performed.
methodsA cost-effectiveness analysis compared the approach of initial placement of PES versus SEMS for the study population. Patients with malignant biliary obstruction underwent an endoscopic retrograde cholangiopancreatography to insert the initial stent. If the insertion failed, a percutaneous transhepatic cholangiogram was performed. If stent occlusion occurred, a PES was inserted at repeat endoscopic retrograde cholangiopancreatography, either in an outpatient setting or after admission to hospital if cholangitis was present. A third-party payer perspective was adopted. Effectiveness was expressed as the likelihood of no occlusion over the one-year adopted time horizon. Probabilities were based on a contemporary randomized clinical trial, and costs were issued from national references. Deterministic and probabilistic sensitivity analyses were performed.
resultsA PES-first strategy was both more expensive and less efficacious than an SEMS-first approach. The mean per-patient costs were US$6,701 for initial SEMS and US$20,671 for initial PES, which were associated with effectiveness probabilities of 65.6% and 13.9%, respectively. Sensitivity analyses confirmed the robustness of these results.
conclusionAt the time of initial endoscopic drainage for patients with malignant biliary obstruction undergoing palliative stenting, an initial SEMS insertion approach was both more effective and less costly than a PES-first strategy.
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